山西省2010-2014年男男性行为者艾滋病哨点监测结果分析

Analysis of HIV sentinel surveillance among men who have sex with men in Shanxi Province during 2010-2014

目的了解山西省男男性行为者(MSM)的高危行为、艾滋病病毒(HIV)感染状况的变化趋势和影响因素。方法利用山西省2010-2014年MSM哨点监测数据,分析其人口学特征、高危行为状况和HIV抗体阳性率水平及其变化趋势,并采用二分类Logistic回归分析MSM感染HIV的影响因素。结果2010-2014年共监测MSM 4669人,HIV抗体阳性率分别为5.8%(45/776)、8.0%(68/885)、8.3%(76/912)、8.3%(88/1055)、8.2%(88/1071)。最近6个月肛交坚持使用安全套的比例在41.8%左右,监测对象的艾滋病知识知晓率、最近1次肛交安全套使用率呈上升趋势(P<0.05),最近6个月有商业同性性行为的比例、有异性性行为的比例呈逐年下降趋势(P<0.05)。外省户籍、梅毒抗体阳性、样本来源为自愿咨询检测门诊、高年龄是该人群感染HIV的危险因素;而最近6个月有异性性行为、最近1年接受艾滋病干预服务是保护因素。结论山西省MSM艾滋病知识知晓率有所提高,但危险行为及安全套使用情况未见有效改善,HIV抗体阳性率较高。应加强对MSM的干预,探索针对MSM的有效干预手段。

Objective To understand HIV prevalence and risk behaviors among men who have sex with men （MSM） in Shanxi from 2010 to 2014. Methods MSM were recruited for the national HIV sentinel surveillance. Demographic information, HIV related risk behaviors and results of HIV and syphilis infections were analyzed. Lo- gistic regression model was made to identifyinfluence factors of HIV infection. Results The total number of 4669 MSMwas under survey. The prevalence of HIV infection was 5.8%（45/776）.8.0%（68/885）.8.3%（76/912）、 8.3%（88/1055）, and 8.2%（88/1071）respectively. The rate of consistent condom use in anal sex with male part- ners in the past six months was around 41.8%. The awareness rate of AIDS knowledge and the rate of condom use the last anal sex increased （P〈O. 05）. Meanwhile the proportions of commercial homosexual and heterosexual be- haviors in the past six months showed a downward trend year by year（P〈0.05）. Non-local residents, syphilis in- fection, those from VCT clinics and elder age were factors associated with HIV infection. Protection factors includ- ed having heterosexual behavior in the past six months and being intervened in the last year. Conclusion The awareness rate of HIV knowledge among MSM increases while the high-risk behaviors and constant condom use re- main unchangeable. HIV prevalence among MSM is relatively higher. More intervention efforts should be targeted to MSM.